Cm Increase In Waist Circumference Research Articles

The Relationship of Waist Circumference with the Morbidity of Cardiovascular Diseases and All-Cause Mortality in Metabolically Healthy Individuals: A Population-Based Cohort Study.

This study explores the relationship between waist circumference and morbidity of cardiovascular diseases (CVD) and all-cause mortality in metabolically healthy individuals. A cohort of 5775 metabolically healthy participants from the 2001-2014 US National Health and Nutrition Examination Survey and National Death Index database was tracked over a median period of 81 months. These participants were divided into quartiles (Q1, Q2, Q3, Q4) based on increasing waist circumference. To compensate for missing covariates, multivariate multiple imputation methods were used. Adjusted logistic regression models were employed to examine the correlation between waist circumference and cardiovascular disease prevalence. Furthermore, Kaplan-Meier curves and multivariable Cox regression analysis were utilized to evaluate the association between waist circumference and all-cause mortality, both qualitatively and quantitatively. The adjusted logistic regression model indicated that a 10 cm increase in waist circumference was associated with a 1.45 times higher prevalence of CVD. As a categorical variable, there was a significant upward trend in CVD incidence across quartiles of waist circumference. The adjusted odds ratios (95% confidence intervals) were 2.41 (1.13-5.53) for Q2, 2.65 (1.18-6.39) for Q3, and 2.53 (0.9-7.44) for Q4, compared to Q1. Notably, individuals with high waist circumference showed significantly poorer survival compared to those with low waist circumference (p = 0.008). The Cox regression analysis revealed that each 10 cm increase in waist circumference contributed to an ~8% increase in all-cause mortality. This study underscores a positive correlation between waist circumference and both CVD morbidity and all-cause mortality in metabolically healthy individuals. The findings highlight the significance of routinely monitoring waist circumference for effective CVD risk management, regardless of metabolic health status.

#299 The association between body fat distribution, albuminuria, and mortality in relatively healthy adults

Abstract Background and Aims Albuminuria is a risk factor for kidney disease progression and cardiovascular disease (CVD). Metabolic syndrome has been associated with incident albuminuria. We aimed to understand which measures of adiposity are associated with albuminuria and mortality in relatively healthy adults. Method We included 8,215 adults in the National Health and Nutrition Examination Survey (years 2003-6 and 2011-2016) without prior CVD, estimated glomerular filtration rate <60 ml/min/1.73 m2 (eGFR), diabetes, hypertension, or prior dialysis. We used multivariable adjusted linear regression modelling to evaluate sex-stratified relationships between urine albumin excretion and multiple measures of adiposity, controlling for urine creatinine. We then performed sex-stratified multivariable adjusted Cox regression models of the association between adiposity and all-cause mortality. Measures of adiposity included android fat mass index (FMI), gynoid FMI, android-to-gynoid ratio, subcutaneous FMI, abdominal FMI, visceral FMI, body mass index (BMI), and waist circumference. Models were adjusted for age, race or ethnicity, education, food insecurity, health insurance, survey year, physical activity, eGFR, total cholesterol, systolic blood pressure, hemoglobin A1c, and urine albumin:creatinine ratio (UACR), and menopausal status (among women). Models were subsequently adjusted for BMI and waist circumference. Results The sample was 52.3% women, the mean (standard deviation, SD) BMI was 27.1 kg/m2 (SD 6.7), and the median UACR was 5.4 mg/g [3.8, 8.6]. Over a median follow up of 7.8 years [IQR 5.3-14.3], there were 128 deaths among men and 89 deaths among women. Among men, a 1-SD increase in android fat mass index (FMI) was associated with 13.1% (95% CI 4.5, 22.5) higher albuminuria. Similarly, a 1-SD increase in visceral FMI was associated with 8.3% (95% CI 1.3, 15.7) higher albuminuria. BMI was non-linearly associated with albuminuria among men. Among women, a 1-unit increase in android to gynoid ratio was associated with 47.7% lower albuminuria (% change = −47.7 (95% CI −61.4, −29.3). A 5 kg/m2 increase in BMI was associated with 11.0% lower albuminuria (% change = −11.0 (95% CI −15.0, −6.7) and a 3 cm increase in waist circumference was associated with 1.6% (95% CI 0.03, 3.0) higher albuminuria. Among men, a 1-SD increase in abdominal FMI was associated with 2.09-fold higher risk of all-cause mortality (HR 2.09 [95% CI 1.16-3.74]), independent of BMI and waist circumference. Among women, a 1-SD increase in gynoid FMI was associated with 56% decreased risk of all-cause mortality (HR 0.44 [95% CI 0.20-0.88]), independent of BMI and waist circumference. Conclusion Adiposity is differently associated with albuminuria and mortality in relatively healthy men and women. Sex-specific patterns of adipose deposition may inform CVD risk stratification.

Surgical methods of treatment for tibial diaphyseal fractures

Background. Bone fractures are a public health concern. In recent years, there has been an upward trend in body weight of people of all age groups. Obesity has long been thought to help protect against fractures, but recent studies have shown that for every 5 cm increase in waist circumference, the risk of any fracture is 3 % higher. The purpose: according to the meta-analysis of modern medical literature, to determine the main directions of surgical treatment for long bone fractures, their advantages, and disadvantages, including in overweight patients, the features of diaphyseal fracture fixation in overweight patients. Materials and methods. A meta-analysis of special literature from scientific databases was conducted: Cochrane Library, Scopus, National Library of Medicine — National Institutes of Health, ReLAB-HS Rehabilitation Resources Repository. One hundred and thirty articles were analyzed, from them 31 were selected, which, in our opinion, reflect the purpose of the study. Results. All methods of surgical fixation of fractures have their advantages and disadvantages. The frequency of nonunions caused by intramedullary fixation of the femoral shaft can reach 10 %, and varus/valgus and rotational deformities and shortening can also be observed. But the use of locking screws prevents the occurrence of most complications. When fixing the fractures with plates, the main complications are related to superficial and deep infections, which were more often observed in overweight patients. The analysis demonstrated that in overweight and obese patients, the main complicating factor is not the method for fixing the fracture zone, but factors related to the health of the patient himself. So, despite the fact that the results of treatment of fractures in patients with normal weight and obesity did not have a statistically significant difference, an increase in cardiovascular complications, exacerbation of chronic respiratory diseases was observed. Moreover, it is the presence of concomitant diseases that often makes surgical intervention impossible. Conclusions. There is a large amount of research on surgical methods of fixing tibial diaphyseal fractures, but data on the choice of fixation method in overweight and obese patients as a separate approach were not found. There are data on complicating factors of excess weight in the treatment of fractures and surgical interventions. Systematic studies related specifically to the algorithm for choosing the method of fracture fixation and complications have also not been found.

Investigating the causal association of generalized and abdominal obesity with microvascular complications in patients with type 2 diabetes: A community-based prospective study.

The paradoxical protective association between overweight/obesity and diabetic microvascular complications (DMC), a phenomenon well-known as the obesity paradox, has been considered a non-causal association based on methodological influences. We aimed to investigate the association of generalized and abdominal obesity, as measured by body mass index (BMI) and waist circumference (WC), respectively, with DMC in patients with type 2 diabetes (T2D), using a causal inference approach. We enrolled 1436 patients with clinically diagnosed T2D but not DMC at baseline in a community-based prospective cohort in China between 2017 and 2019 and followed them annually until 2022 with new-onset DMC recorded. Marginal structural Cox models with inverse probability weighting were constructed to determine the causal association. Subgroup analyses were performed to identify potential effect modifiers. We observed 360 incident DMC cases, including 109 cases of diabetic nephropathy (DN) and 277 cases of diabetic retinopathy (DR) during four follow-up visits. Multivariable-adjusted hazard ratios (95% confidence intervals) for overall DMC, DN and DR were 1.037 (1.005-1.071), 1.117 (1.062-1.175) and 1.018 (0.980-1.059) for 1 kg/m2 increase in BMI, and 1.005 (0.994-1.017), 1.034 (1.018-1.051) and 1.000 (0.987-1.014) for 1 cm increase in WC, respectively. Similar patterns were observed across the BMI and WC categories, while the positive association appeared to be more pronounced in women. Generalized but not abdominal obesity was associated with an increased risk for the overall DMC, whereas both obesities were causally related to DN, albeit not DR, in T2D. Routine weight management should not be neglected in diabetes care, particularly in women.

The association between waist circumference and adult asthma attack using nationally representative samples

AimsThis study aims to explore the relationship between waist circumference and asthma attack in adults.MethodsIn this cross-sectional study, we analysed data from 5,530 U.S. adults diagnosed with asthma. Participants were categorized into two groups based on their experience of asthma attacks: with or without asthma attacks. We employed adjusted weighted logistic regression models, weighted restricted cubic splines, subgroup and sensitivity analyses to assess the association between waist circumference and asthma attack.ResultsThe median age of all participants was 43 years, and the median waist circumference was 98.9 cm, with a median BMI was 28.50 kg/m2. Participants in the asthma attack group had significantly higher waist circumferences than those in the non-attack group (P < 0.001). After full adjustment for body mass index-defined obesity, age, gender, race, education levels, poverty income ratio levels, smoking status, and metabolic syndrome, every 5 cm increase in waist circumference exhibited a 1.06 times higher likelihood of asthma attack probability. The weighted restricted cubic spline analysis demonstrated an increased risk of asthma attacks with rising waist circumference. Subgroup analyses confirmed this relationship across various groups differentiated by gender, age, and smoking status. When applying a stricter definition of asthma attack, the weighted logistic regression models showed robust association between waist circumference and asthma attack.ConclusionWaist circumference is an independent predictor of asthma attacks. Our findings underscore the importance of waist circumference measurement in evaluating the risk of asthma attacks.

Association between waist circumference and female infertility in the United States.

Obesity has significant implications for fertility and reproductive health. However, evidences linking abdominal obesity to female infertility were limited and inconclusive. Our objective was to figure out the potential relationship between waist circumference (WC) and infertility among women of childbearing age in the United States using data from the National Health and Nutrition Examination Survey (NHANES). Our cross-sectional study included 3239 female participants aged 18-45 years. To explore the independent relationship between WC and female infertility, the weighted multivariable logistic regression and smoothed curve fitting were performed. Interaction and subgroup analyzes were then conducted for secondary analysis. WC was positively associated with female infertility independent of BMI after adjusting for BMI and other potential confounders. In fully adjusted model, for every 1cm increase in waist circumference, the risk of infertility increased by 3% (OR = 1.03, 95% CI: 1.01-1.06). When WC was divided into five equal groups, women in the highest quintile had 2.64 times risk of infertility than that in the lowest quintile (OR = 2.64, 95% CI: 1.31-5.30). Smooth curve fitting revealed a non-linear but positively dose-dependent relationship between WC and female infertility. Furthermore, we found an inverted U-shaped relationship (turning point: 113.5 cm) between WC and female infertility in participants who had moderate recreational activities and a J-shaped relationship (turning point: 103 cm) between WC and female infertility in participants who had deficient recreational activities. Waist circumference is a positive predictor of female infertility, independent of BMI. Moderate recreational activities can lower the risk of female infertility associated with abdominal obesity.

Added value of waist circumference to body mass index for predicting fracture risk in obesity: a prospective study from the CARTaGENE cohort.

Waist circumference (WC) is a stronger risk factor of metabolic disorders than body mass index (BMI), but whether it holds true for fracture risk prediction remains unclear. We aimed to evaluate relationships between WC and fracture incidence within BMI categories and evaluate whether BMI modifies these relationships. Men and women aged 40-70years from the CARTaGENE cohort were divided by BMI category at baseline: normal weight, overweight, and obesity. Incident fractures were identified over 7years via linkage with healthcare administrative databases. Cox proportional hazard models estimated the relationships between WC and incident fractures at any site and by skeletal site within each BMI category. Results are reported as adjusted hazard ratios (95% confidence intervals) per 10cm increase in WC. Effect modification was evaluated qualitatively by comparing relationships between BMI categories. Of the 18 236 individuals included, 754 sustained a fracture. Significant relationships were found between WC and distal lower limb fractures in the normal (1.25 [1.08, 1.45]) and overweight (1.28 [1.07, 1.52]) BMI categories, but not in the obesity category. In the overweight category, we found an increased risk of distal upper limb fractures with increasing WC (1.49 [1.04, 2.15]). No significant relationship was observed regarding WC and fracture risk at any site or major osteoporotic fractures. An effect modification of BMI on the relationships between WC and distal lower limb fractures was observed. WC provides both independent and additive information to BMI for the identification of individuals at risk of obesity-related fractures.

The association between body mass index, abdominal fatness, and weight change and the risk of adult asthma: a systematic review and meta-analysis of cohort studies

Obesity has been associated with increased risk of adult asthma, however, not all studies have found a clear association between overweight and the incidence of asthma, and data on other adiposity measures have been limited. Hence, we aimed to summarize evidence on association between adiposity and adult asthma. Relevant studies were retrieved through searches conducted in PubMed, and EMBASE up to March 2021. A total of sixteen studies (63,952 cases and 1,161,169 participants) were included in the quantitative synthesis. The summary RR was 1.32 (95% CI 1.21–1.44, I2 = 94.6%, pheterogeneity < 0.0001, n = 13) per 5 kg/m2 increase in BMI, 1.26 (95% CI 1.09–1.46, I2 = 88.6%, pheterogeneity < 0.0001, n = 5) per 10 cm increase in waist circumference and 1.33 (95% CI 1.22–1.44, I2 = 62.3%, pheterogeneity= 0.05, n = 4) per 10 kg increase in weight gain. Although the test for nonlinearity was significant for BMI (pnonlinearity < 0.00001), weight change (pnonlinearity = 0.002), and waist circumference (pnonlinearity = 0.02), there was a clear dose-response relationship between higher levels of adiposity and asthma risk. The magnitude of the associations and the consistency of the results across studies and adiposity measures provide strong evidence that overweight and obesity, waist circumference and weight gain increases asthma risk. These findings support policies to curb the global epidemic of overweight and obesity.

Delayed bedtime on non-school days associates with higher weight and waist circumference in children: Cross-sectional and longitudinal analyses with Mendelian randomisation.

Sleep duration has been linked with obesity in population-based studies. Less is known about bedtimes and, especially, if discrepancy between bedtimes on school and non-school days associate with adiposity in children. The associations of self-reported bedtimes with the body mass index z-score (BMIz) and waist-to-height ratio (WtHr) were examined among children with a mean (SD) age of 11.2 (0.85) years in cross-sectional (n=10,245) and longitudinal (n=5085) study settings. The causal relationship of whether BMIz contributes to bedtimes, was further examined in a subset of 1064 participants by exploiting Mendelian randomisation (MR). After adjusting for sleep duration and other confounders, every 0.5 h later bedtime on non-school nights and a delay in bedtime in non-school nights compared with school nights associated with 0.048 (95% CI 0.027; 0.069) and 0.08 (95% CI 0.056; 0.105) higher BMIz as well as 0.001 (95% CI 0; 0.002) and 0.004 (95% CI 0.003; 0.005) with higher WtHr, respectively. Moreover, every 0.5-h delay in bedtime in non-school nights compared with school nights associated with 0.001 (95% CI 0; 0.002) greater increase in WtHr in the 2.5 years follow-up. Thus, a 2-h delay in bedtime at the age of 11 years corresponds with a 0.6 cm increase in waist circumference. The MR analysis did not indicate an opposite causal relationship: higher BMIz was not causing delayed bedtimes. Later bedtime on non-school days and discrepancy in bedtimes associated with increased BMIz and WtHr, while longitudinally these predicted higher WtHr, independently of sleep duration. Promoting early bedtimes, especially on weekends, should be considered in obesity prevention among school-aged children.

Different associations between waist circumference and bone mineral density stratified by gender, age, and body mass index

IntroductionInvestigations of the relationship between waist circumference (WC) and bone mineral density (BMD) have inconsistent and incomprehensive results.We explored the association between WC and BMD at various sites in a large-scale population-based study.MethodsWe screened 5337 participants from National Health and Nutrition Examination Survey (NHANES) database. BMD was measured using dual-energy X-ray absorptiometry at various skeletal sites. The associations of WC with BMD were evaluated by weighted multivariable logistic regression models and conducted subgroup analyses for gender, age, and BMI. A weighted generalized additive model and a smooth curve fitting were performed to address non-linearity.ResultsAdjustments for all confounders, in males, WC was negatively correlated to BMD in different age and BMI groups (all the p < 0.05), except for in the lowest BMI group; in females, overall trends of relationships between WC and BMD were negative. However, statistical differences were insignificant in some cases. Additionally, every 1 cm increase in WC for individuals of all ages with normal BMI (18.5 ≤ BMI < 25) was associated with decrease in BMD at each skeletal site, as was the case for men with BMI ≥ 25 kg/m2. For women, the negative association of WC with BMD was evident at the lumbar spine in the youngest age group (8 ≤ Age ≤ 18) with normal BMI.ConclusionsThe nonlinear associations between WC and BMD at various skeletal sites are gender-, age- and BMI-specific in the NHANES (2006–2006).

Sex and race define the effects of adverse childhood experiences on self-reported BMI and metabolic health biomarkers

BackgroundAdverse childhood experiences (ACEs) are an independent risk factor for chronic diseases, including type 2 diabetes, stroke and ischemic heart disease. However, the effect of ACEs considering sex and race are not often reported in cohorts showing multiracial composition, with power to evaluate effects on underrepresented populations.AimTo determine how sex and race affected the association of combined and individual ACEs with metabolic health biomarkers in the Southern Community Cohort Study (2012–2015).MethodsSelf-reported data were analyzed from ACE surveys performed during the second follow-up of a cohort comprised by over 60% of Black subjects and with an overall mean age of 60 years.ResultsBMI steadily increased with cumulative ACEs among Black and White women, but remained relatively stable in White men with ≥ 4 ACEs. Contrary, Black men showed an inverse association between ACE and BMI. Secondary analysis of metabolic outcomes showed that physical abuse was correlated with a 4.85 cm increase in waist circumference in Black subjects. Total cholesterol increased among individuals with more than 4 ACEs. In addition, increases in HbA1c were associated with emotional and maternal abuse in Black women and sexual abuse in White women.ConclusionsBMI is strongly associated with cumulative ACEs in women regardless the race, while waist circumference is strongly associated with ACEs in Black individuals, which combined with reduced BMI may indicate increased central adiposity in Black men. Our study suggests that sex and race influence the contribution of certain ACEs to impair metabolic health.

Higher Abdominal Adiposity Is Associated With Lower Muscle Strength in Chilean Adults.

Handgrip strength (HGS) is a well-established indicator of muscle strength and a reasonable clinical predictor of metabolic health and diseases. This study explores the association between relative muscular strength and abdominal obesity (AO) in healthy Chilean adults. A convenience sample was recruited (n = 976) between 2018 and 2020. The HGS was determined by dynamometry. The anthropometry (weight, height, waist, and mid-arm circumference) and physical activity were also measured. The relative HGS (RHGS) was calculated by dividing the maximum HGS of the dominant hand by the body mass index. The AO was defined as a waist circumference (WC) >88 cm for women, and >102 cm for men. From the sample, 52.6% were women, 56.4% had excessive weight, and 42.7% had AO. The absolute and RHGS were greater in men compared to women (p < 0.001) and were decreased with age in both sexes. We observed a moderate negative correlation between WC and RHGS (rho = −0.54, and rho = −0.53, for men and women, respectively). The RHGS was lower in individuals with AO, independent of age and sex (p < 0.05). For each cm increase in WC, the odds of low RHGS (<25th percentile) increased by 12 and 9% for men and women, respectively. The AO is related to higher odds for low RHGS (OR: 1.72; 95% CI: 1.23–2.41). In our sample of healthy adults, a higher AO was associated with a lower muscle strength measured by dynamometry.

Associations of body mass index and waist circumference with hospitalization risk of kidney stones in Chinese adults

Objective: To evaluate the associations of body mass index (BMI) and waist circumference with hospitalization risk of kidney stones in Chinese adults. Methods: This study used long-term follow-up data from China Kadoorie Biobank. After excluding participants with chronic kidney disease, cancer, and extreme BMI or waist circumference values at baseline, 502 096 participants were included in the present analysis. Cox proportional hazards regression models were used to estimate the associations of BMI and waist circumference with hospitalization risk of kidney stones. Results: During an average follow-up period of (10.7±2.2) years, 12 396 participants were hospitalized for the first time with kidney stones. Using the participants with BMI (kg/m2) of 20.5-22.4 as reference, the multivariable-adjusted HR (95%CI) for those with BMI of <18.5, 18.5-20.4, 22.5-23.9, 24.0-25.9, 26.0-27.9, 28.0-29.9, and ≥30.0 were 0.96 (0.87-1.05), 0.94 (0.88-1.00), 1.11 (1.05-1.17), 1.25 (1.18-1.32), 1.29 (1.21-1.37), 1.39 (1.28-1.50), and 1.54 (1.40-1.71), respectively. For every 1 kg/m2 increase in BMI, the HR of kidney stones hospitalization increased by 4% (HR=1.04, 95%CI: 1.04-1.05). Using the participants with waist circumference (cm) of 75.0-79.9 as reference, the multivariable-adjusted HR (95%CI) for those with waist circumference of <65.0, 65.0-69.9, 70.0-74.9, 80.0-84.9, 85.0-89.9, 90.0-94.9, and ≥95.0 were 0.82 (0.74-0.91), 0.85 (0.80-0.92), 0.95 (0.89-1.00), 1.16 (1.09-1.22), 1.22 (1.15-1.30), 1.28 (1.19-1.38), and 1.46 (1.35-1.58), respectively. For every 5 cm increase in waist circumference, the HR of kidney stones hospitalization increased by 9% (HR=1.09, 95%CI: 1.08-1.10). After mutually adjusting for BMI and waist circumference in the above models, the association between BMI and hospitalization risk of kidney stones disappeared. In contrast, the association between waist circumference and hospitalization risk of kidney stones remained unchanged. Conclusions: BMI and waist circumference were positively associated with hospitalization risk of kidney stones. The increased waist circumference was an independent risk factor for kidney stones among Chinese adults.

Relation of Abdominal Obesity to Risk of Atrial Fibrillation (From the Reasons for Geographic and Racial Differences in Stroke [REGARDS] Study)

Our knowledge of the association between abdominal obesity (AO) and the risk of atrial fibrillation (AF) after adjusting for body mass index (BMI) is limited. We included 11,617 Black and White participants (mean age 63.0 ± 8.4 years) from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) national cohort study who were free of AF at baseline. A multivariable logistic regression model was used to estimate the odds ratio (OR) with 95% confidence interval (CI) of incident AF associated with AO. We also evaluated the association between waist circumference (WC) and incident AF. Over a median follow-up of 9.4 years, 999 participants developed AF. AO was associated with an increased risk of AF in a multivariable model adjusted for sociodemographic, lifestyle, and cardiovascular risk factors (OR 1.43, 95% CI 1.24 to 1.65, p <0.001). The association was attenuated after adjusting for BMI (OR 1.13, 95% CI 0.95 to 1.35, p=0.16). There was no evidence of interaction between AO and incident AF by age category (age >65 vs age ≤65), gender, race, obesity, or BMI category. Conversely, a 10cm increase in WC was associated with a higher incidence of AF after controlling for BMI (OR 1.18 95% CI 1.09 to 1.29, p <0.001), in both nonobese (OR 1.14, 95% CI 1.03 to 1.28, p=0.02) and obese (OR 1.26, 95% CI 1.11 to 1.42, p <0.001) people. In conclusion, there was an association between AO and incident AF, but the association was weakened after adjusting for BMI. There was a significant association between WC and incident AF, after taking other AF risk factors and BMI into account. WC is a potentially modifiable risk factor for AF, and further research is warranted to explore the effect of decreasing WC on the population AF burden.

Cross-sectional relation of long-term glucocorticoids in hair with anthropometric measurements and their possible determinants: A systematic review and meta-analysis.

SummaryBackgroundLong‐term glucocorticoids (HairGC) measured in scalp hair have been associated with body mass index (BMI), waist circumference (WC), and waist‐hip‐ratio (WHR) in several cross‐sectional studies. We aimed to investigate the magnitude, strength, and clinical relevance of these relations across all ages.MethodsWe performed a systematic review and meta‐analysis (PROSPERO registration CRD42020205187) searching for articles relating HairGC to measures of obesity. Main outcomes were bivariate correlation coefficients and unadjusted simple linear regression coefficients relating hair cortisol (HairF) and hair cortisone (HairE) to BMI, WC, and WHR.ResultsWe included k = 146 cohorts (n = 34,342 individuals). HairGC were positively related to all anthropometric measurements. The strongest correlation and largest effect size were seen for HairE‐WC: pooled correlation 0.18 (95%CI 0.11–0.24; k = 7; n = 3,158; I 2 = 45.7%) and pooled regression coefficient 11.0 cm increase in WC per point increase in 10‐log‐transformed HairE (pg/mg) on liquid‐chromatography‐(tandem) mass spectrometry (LC–MS) (95%CI 10.1–11.9 cm; k = 6; n = 3,102). Pooled correlation for HairF‐BMI was 0.10 (95%CI 0.08–0.13; k = 122; n = 26,527; I 2 = 51.2%) and pooled regression coefficient 0.049 kg/m2 per point increase in 10‐log‐transformed HairF (pg/mg) on LC–MS (95%CI 0.045–0.054 kg/m2; k = 26; n = 11,635).DiscussionThere is a consistent positive association between HairGC and BMI, WC, and WHR, most prominently and clinically relevant for HairE‐WC. These findings overall suggest an altered setpoint of the hypothalamic–pituitary–adrenal axis with increasing central adiposity.

Changes in Sugar Sweetened Beverage Intake Related to Changes in Body Composition in Mexican Adolescents

ObjectivesTo examine the relationship between changes in sugar sweetened beverage (SSB) intake and changes in adiposity over a two-year period during adolescence in a Mexico City cohort. MethodsThe analytic sample comprised 511 Mexican adolescents enrolled in a birth cohort study with complete information on sugar sweetened beverage intake and body composition for two time points. In 2015 and 2017, a food frequency questionnaire (FFQ) from the 2006 Mexican National Health and Nutrition Survey was administered to participants ages 9 to 20. Seven variables from the FFQ were summed to use as daily servings of SSBs as a predictor: regular soda, coffee with sugar, tea with sugar, sweetened fruit water, chocolate milk, corn atole, and Yakult (sweetened probiotic milk beverage). Adiposity measurements included body mass index (BMI), body fat % estimated by bioelectrical impedance, and waist circumference, measured by trained research assistants using standard techniques. We used linear regression models with changes in adiposity measures as the continuous outcome and quartiles of change in sugar sweetened beverage intake as the predictor adjusting for age, sex, household socioeconomic status, screen time, and physical activity. ResultsAt baseline (2015), mean age was 14.5 ± 2.1 years with 48% male. The median intake of SSBs was 341 mL/day (IQR = 463 mL) for males and 257 mL/day (IQR = 391 mL) for females. The median SSB intake change over the 2-year period was a 51 mL decrease (IQR = 441 mL) for males and no change (IQR = 360 mL) for females. In adjusted analyses, adolescents with the highest change in SSB intake (Quartile 4,274.3 mL median (IQR = 297.1) increase in SSB intake) had a 0.30 increase kg/m2 in BMI (95% CI –0.15, 0.75), a 1.14% increase in body fat (95% CI –0.02, 2.31), and a 1.64 cm increase in waist circumference (95% CI 0.27, 3.00), compared to those with decreases or no change in SSB intake. ConclusionsIncreased intake of sugar sweetened beverages was associated with higher changes in body fat percentage, waist circumference, and BMI over a two-year period among Mexican adolescents. Funding SourcesThis project was supported by a P01 research grant through the NIH/NIEHS.

High Body Mass Index and Central Adiposity Is Associated with Increased Risk of Acute Pancreatitis: A Meta-Analysis

BackgroundHigher body mass index and waist circumference have been associated with increased risk of pancreatitis in several prospective studies; however, the results have not been entirely consistent.AimsWe conducted a systematic review and dose-response meta-analysis of prospective studies on adiposity and risk of pancreatitis to clarify this association.MethodsPubMed and Embase databases were searched for studies on adiposity and pancreatitis up to January 27, 2020. Prospective studies reporting adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) for the association between adiposity and risk of pancreatitis were included, and summary RRs (95% CIs) were calculated using a random effects model.ResultsTen prospective studies with 5129 cases and 1,693,657 participants were included. The summary RR (95% CI) of acute pancreatitis was 1.18 (95% CI: 1.03–1.35, I2 = 91%, n = 10 studies) per 5 kg/m2 increase in BMI and 1.36 (95% CI: 1.29–1.43, I2 = 0%, n = 3) per 10 cm increase in waist circumference. There was evidence of a nonlinear association between BMI and acute pancreatitis, pnonlinearity < 0.0001, with a steeper association at higher levels of BMI, but not for waist circumference, pnonlinearity = 0.19. Comparing a BMI of 35 with a BMI of 22, there was a 58% increase in the RR and there was a fourfold increase in the RR comparing a waist circumference of 110 cm with 69 cm. There was no evidence of publication bias.ConclusionsThis meta-analysis suggests that both increasing BMI and waist circumference are associated with a dose-response-related increase in the risk of acute pancreatitis.

Body mass index, abdominal fatness, weight gain and the risk of urinary incontinence: a systematic review and dose-response meta-analysis of prospective studies.

Adiposity has been associated with elevated risk of urinary incontinence in epidemiological studies; however, the strength of the association has differed between studies. To conduct a systematic literature review and dose-response meta-analysis of prospective studies on adiposity and risk of urinary incontinence. We searched PubMed and Embase databases up to 19 July 2017. Prospective cohort studies were included. Data were extracted by one reviewer and checked for accuracy by a second reviewer. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random effects models. Twenty-four prospective studies were included. The summary RR per 5kg/m2 increment in body mass index (BMI) was 1.20 (95% CI 1.16-1.25, I2 =62%, n=11) for population-based studies and 1.19 (95% CI 1.08-1.30, I2 =87.1%, n=8) for pregnancy-based studies, 1.18 (95% CI 1.14-1.22, I2 =0%, n=2) per 10cm increase in waist circumference and 1.34 (95% CI 1.11-1.62, I2 =90%, n=2) per 10kg of weight gain. Although the test for nonlinearity was significant for BMI, P=0.04, the association was approximately linear. For subtypes of urinary incontinence the summary RR per 5 BMI units was 1.45 (95% CI 1.25-1.68, I2 =85%, n=3) for frequent incontinence, 1.52 (95% CI 1.37-1.68, I2 =34%, n=4) for severe incontinence, 1.33 (95% CI 1.26-1.41, I2 =0%, n=8) for stress incontinence, 1.26 (95% CI 1.14-1.40, I2 =70%, n=7) for urge incontinence, and 1.52 (95% CI 1.36-1.69, I2 =0%, n=3) for mixed incontinence. These results suggest excess weight may increase risk of urinary incontinence. Overweight and obesity increase the risk of urinary incontinence.

The Impact of Abdominal Obesity on Cardiopulmonary Fitness in Chinese Heart Failure Patients

Introduction There is an inverse relationship between abdominal obesity measured by waist circumference (WC) and cardiopulmonary fitness (peak oxygen consumption, VO2peak) among healthy white people. However, knowledge of Chinese heart failure patients remains scant because heart failure patients generally experience significant impaired cardiopulmonary fitness, and Asian populations tend to have more abdominal fat compared to white populations. Hypothesis Abdominal obesity based on Asian WC cut-off points results in significant changes in VO2peak and the WC can negatively impact the VO2peak in Chinese heart failure patients. Methods This is a cross-sessional study. Data was collected from 72 heart failure patients with NYHA classI∼IV (80% II) with mean ejection fraction of 46.5%. VO2peak was measured during a symptom-limited bicycle exercise test; and WC was measured between the lower rib and the iliac crest. Abdominal obesity was defined by the recommended Asian cut-off points (90 cm for men, 85 cm for women). Other clinical variables were collected from electronic medical records. Non-parametric tests, Spearman's correlation coefficients, and a linear regression model were used with p-value Results Among 72 patients, mean age was 65.4 (range: 36∼91); 80.6% were male; and mean BMI was 24.4 kg/m2 with 45 (63%) classified as abdominally obese. Overall, significant lower VO2peak value was found in the abdominal obesity group including men and women (-2.6 mL/kg/min, 95%CI: -4.5, -0.8) than in the normal WC group. When patients were stratified into two gender groups and three age groups (young: Conclusion Recommended Asian WC thresholds for abdominal obesity are a useful instrument for detecting clinically, statistically relevant decreases in VO2peak among Chinese heart failure patients. For male patients or those under 60, WC was inversely associated with their VO2peak. For each 5∼6cm increase in WC, reducing VO2peak showed a clinically significant decrease of 1 mL/kg/min among Chinese heart failure patients. Further research with larger samples sizes is needed to support WC as a cardiopulmonary fitness self-management tool.

Associations of Changes in Weight and Waist Circumference with Cardiovascular Disease and Mortality in Chinese Adults

Background: The associations of age-related changes in body weight and waist circumferences with cardiovascular disease (CVD) and mortality remain unclear. Methods: We assessed changes in weight and waist circumference from baseline survey and resurvey among 27 964 participants in the China Kadoorie Biobank (CKB, 2004-2008) and Dongfeng-Tongji Cohort (DF-TJ, 2008-2013). We used Cox proportional hazards models to evaluate the associations between adiposity changes and the subsequent risks of incident CVD, CVD mortality and all-cause mortality. Findings: On average, during a median of 3·4 years from baseline to resurvey, participants experienced a weight loss of 0·6 kg, accompanied by a 2·1 cm increase in waist circumference. We identified 3589 incident CVD cases, 485 CVD deaths, and 1283 all-cause deaths during the follow-up in the CKB (2008-2016) and DF-TJ (2013-2016). Weight loss and waist gain were associated with increased risks of those outcomes in the two cohorts. In particular, compared with participants who had stable waist (waist change -2·0 to 7·0 cm) and weight (weight change -2·5 to 2·5 kg), those who gained waist but lost weight (waist circumference change >7·0 cm, weight change ≤ -2·5 kg) had the highest risk of incident CVD, CVD mortality and all-cause mortality, with the pooled multivariate hazard ratios (HRs) of 1·41 (95% CI, 1·13 to 1·75), 2·48 (1·40 to 4·37), and 1·71 (1·16 to 2·51), respectively. Among the weight-stable participants, waist circumference was linearly associated with CVD risk, with 17% higher risk (HR 1·17, 1·04 to 1·32) for those gained waist while 13% lower risk (HR 0·87, 0·77 to 0·99) for those lost waist compared to waist-stable participants. Interpretation: Increased waist circumference with concurrent weight loss is significantly associated with increased risks of CVD morbidity, CVD mortality, and all-cause mortality among Chinese middle-aged and elderly adults. Funding Statement: This work was partly supported by grants from the Foundation of National Key Programs of Research and Development of China (2016YFC0900800, 2016YFC0900500, 2017YFC0907501 and 2017YFC0907504), the National Natural Science Foundation of China (91643202 and 81390540), the 111 Project and the Program for Changjiang Scholars and Innovative Research Team in University. The China Kadoorie Biobank baseline survey and the first resurvey were supported by the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up has been supported by the UK Wellcome Trust (grants 088158/Z/09/Z, 104085/Z/14/Z), and the Chinese Ministry of Science and Technology (2011BAI09B01). The British Heart Foundation, UK Medical Research Council, and Cancer Research provide core funding to the Clinical Trial Service Unit and Epidemiological Studies Unit at Oxford University for the project. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The CKB study was approved by the ethics committees or institutional review boards at the University of Oxford, the Chinese Center for Disease Control and Prevention (China CDC), the Chinese Academy of Medical Sciences. The DF-TJ cohort was approved by the ethics committees of Tongji Medical College and the Sinopharm Dongfeng General Hospital. All participants provided written informed consents.